[abstract] RECREATIONAL DIVING FATALITIES IN THE UNITED STATES, 1990-1994: PATTERNS AND TRENDS

[abstract] RECREATIONAL DIVING FATALITIES IN THE UNITED STATES, 1990-1994: PATTERNS AND TRENDS

Author:

Caruso, JL; Uguccioni, DM; Mebane, GY; Dovenbarger, JA

Abstract:

BACKGROUND: More than 90 recreational diving fatalities occur in the United States each year. The Divers Alert Network (DAN) gathers information about each fatality and disseminates its findings in an annual report. METHODS: DAN collects all available information concerning recreational diving fatalities that occur in the United States and those that involve U.S. residents diving abroad. By utilizing DAN accident report forms, eyewitness accounts, investigative reports, newspaper articles, and autopsy findings an attempt is made to learn all of the circumstances surrounding the incident. Each case is reviewed by physicians with experience in both diving and forensic medicine. A synopsis of each fatality and a review of the most common causes of diving associated mortality are published by DAN each year. Available data from the years 1990 - 1994 was examined for potential trends among the 445 diving related fatalities. RESULTS: In cases where the diver's certification and experience level were known (N = 307), 33 (10.7percent) involved uncertified divers, another 23 (7.5percent) involved divers in their initial open water certification, and in 217 (70.7percent) cases the diver had only basic open water certification. Among the certified divers, 40 (14.6percent) had made fewer than 6 dives and another 61 (22.3percent) had made fewer than 20 open water dives. 143 divers were considered to be infrequent divers. 103 diving fatalities involved divers making what are typically considered to be specialty dives (e.g. cave, wreck, or deep dives). Only 38 of those 103 divers were formally certified in that particular type of diving. In the 390 cases where information regarding a dive buddy was available, 30 divers were diving alone and 196 others became separated from the dive buddy. The most common medical problem which was either the cause of death or the primary contributing factor was cardiovascular disease. Air embolism was determined to be the primary cause of death or the direct contributing factor in 59 cases. Decompression sickness accounted for 4 fatalities. CONCLUSION: Inexperienced divers are disproportionately represented in fatal diving accidents. Buddy separation and inadequate training for an advanced type of diving are frequently part of a fatal dive profile. Following the recommended safety guidelines can reduce the number of scuba fatalities. Additional training beyond initial open water certification should be strongly encouraged and conservative diving habits for novice divers need to be emphasized. Specific training is necessary for more challenging types of diving. Improved physical screening for older divers and those at risk for cardiovascular disease may decrease the number of diving fatalities.